Introduction of infection control measures to reduce infection associated with implantable pain therapy devices.
Introduction of infection control measures to reduce infection associated with implantable pain therapy devices.
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DOI：
10.1111/j.1533-2500.2007.00142.x
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发表时间：
2007-09-01
期刊：
影响因子：
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通讯作者：
Mauck, W David
中科院分区：
文献类型：
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作者：
Burgher, Abram H;Barnett, Crawford F;Mauck, W David
引言：用于慢性疼痛的植入式疼痛治疗器械包括脊髓刺激器（SCS）和鞘内给药系统（IDDS）。植入这些装置后可能发生许多不同的并发症，但其中最严重的是感染。根据疾病控制和预防中心关于预防手术部位感染的指南、已发表的关于植入式疼痛治疗器械感染风险的文献以及我们自己机构内小组的建议，我们为所有接受SCS或IDDS的患者介绍了感染控制措施。经机构审查委员会批准后，我们对在我们的机构引入安全措施之前和之后接受SCS或IDDS初次植入的患者进行了回顾性分析，这些安全措施旨在减少器械-相关感染。我们比较了感染的发生率和遵守感染预防措施之前和之后引入这些measurement.Results：34 SCS或IDDS植入前实施的感染控制措施和58后放置。发生了5例器械相关感染。在研究期间，对大多数感染预防措施的依从性得到改善，但仅在用于植入的部位观察到100%依从性。感染的发生率下降后，引进的安全措施，但减少不具有统计学意义。结论：介绍植入式疼痛治疗设备的感染控制措施，提高了遵守大多数感染预防措施，在我们的实践。缺乏具体的文件可能会阻碍我们小组内的实践监督。记录感染控制措施执行情况的工具不仅可以作为合规性的标志，而且还可以作为执行某些安全措施的提醒。
INTRODUCTION: Implantable pain therapy devices for chronic pain include spinal cord stimulators (SCS) and intrathecal drug delivery systems (IDDS). A number of different complications can occur after implantation of these devices, but among the most serious is infection. Based on Centers for Disease Control and Prevention guidelines for prevention of surgical site infection, published literature on infection risk with implantable pain therapy devices, and recommendations from groups within our own our institution, we introduced infection control measures for all patients receiving either SCS or IDDS.METHODS: After approval from the Institutional Review Board, we performed a retrospective review of patients undergoing primary implantation of SCS or IDDS before and after introduction at our institution of safety measures designed to reduce device-related infection. We compared infection incidence and compliance to infection precautions before and after introduction of these measures.RESULTS: Thirty-four SCS or IDDS were implanted before implementation of the infection control measures and 58 were placed after. Five device-related infections occurred. Adherence to most infection precautions improved during the study period, but 100% compliance was seen only with venue used for implantation. Infection incidence declined after introduction of the safety measures, but the reduction was not statistically significant.CONCLUSIONS: Introduction of infection control measures for implantable pain therapy devices improved adherence to most infection precautions in our practice. Lack of specific documentation could have hindered practice surveillance within our group. A tool to document performance of infection control measures would be useful not only as a marker of compliance but could also serve as a reminder to perform certain safety measures.